Provider Demographics
NPI:1659785442
Name:MURPHY, LOGAN W (DO)
Entity Type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:W
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-0550
Mailing Address - Country:US
Mailing Address - Phone:606-956-0162
Mailing Address - Fax:
Practice Address - Street 1:432 16TH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7693
Practice Address - Country:US
Practice Address - Phone:606-324-0128
Practice Address - Fax:606-326-1372
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04157207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY04157OtherSTATE LICENSE